Worst outbreak in 20 years, thousands ill

ORISSA IS in the grip of the biggest cholera outbreak to hit India in two decades, with 81 people dying and 3,247 reporting acute diarrhoeal symptoms since July 13. However, state sources put the total number of infected at 3,316 and dead at 103. Most deaths have been reported among tribals living in the Koraput, Rayagada and Kalahandi districts.

“Thirty-one of the 40 human samples collected from two blocks tested positive. Water sources like steams and shallow ponds were also found infected with the cholera bacteria,” said Dr Shiv Lal, director, National Institute of Communicable Diseases, Delhi.

The current outbreak has been caused by the O1 strain, which is milder compared to the O139 strain that had led to an epidemic in Bangladesh. “Though the 01 strain causes milder disease, the death toll has been high due to dehydration brought on by cholera-induced diarrhoea and vomiting,” said Dr Lal, part of the central team that visited the affected districts two days ago.

Cholera is an acute, diarrhoeal disease caused by infection of the intestine with the bacterium Vibrio cholerae. The symptoms are watery diarrhoea and vomiting, which can lead to rapid loss of body fluids. If not treated, dehydration can cause death within hours. The disease does not spread directly from person to person, so casual contact with an infected person is not risky. “The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The cholera bacterium may also live in the environment in brackish rivers and coastal waters,” said Dr Lal.

Cholera can be treated by immediate replacement of lost fluids and salts. “Packaged oral rehydration solutions, a mixture of sugar and salt which is to be dissolved in water, have been sent and people in affected areas have been taught how to use them. Now that health centres have been identified for treatment, none of the 500 patients admitted so far have died,” said Dr Lal.